Comparison of malaria parasites clearance times during quinine and artesunate administration for cerebral malaria in Blantyre Malawi
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Date
2021-03-04
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Kamuzu University of Health Sciences
Abstract
Type of study: This study involves analyzing previously collected data and samples
from cerebral malaria children admitted under Malaria Pathogenesis (MP) study,
therefore; it will be a retrospective cross-sectional study type. The problem: A major current concern is the emergence of malaria resistance to a number of antimalarial drugs including artemisinin derivatives. Possible global
antimalarial drug resistance emergence is threatening the worldwide goal of reducing
the heavy burden of malaria. The global Technical Strategy for malaria 2016-2030
asks countries in endemic regions and all malaria partners to continuously monitor the
effectiveness of anti-malaria drugs in order to contain and prevent the spread of
resistance to other parts of the world. Our goal is to determine if increased usage of
quinine or artesunate has led to increased drug resistance-which would in turn effect
malaria parasite clearance times in children with cerebral malaria. Study Objective:
To compare malaria parasites clearance times during quinine and artesunate
administration periods in cerebral malaria children. Specific Objectives
i. To monitor quinine and artesunate’s effectiveness in treating
Plasmodium falciparum over a period of 3 and 5 years
respectively.
ii. To relate parasite clearance to parasitic load (as measured by
HRP2).
iii. To estimate parasite resistance development to quinine and
artesunate.
iv. To determine proportion of patients who were still parasitaemic
after a standard treatment course of quinine or artesunate. Methodology: We will obtain blood film and Histidine Rich Protein-2 (HRP-2)
concentration data and samples collected from cerebral malaria children admitted
between the years 2010 to 2019. Each child’s blood film results will be arranged in
sequential order of sampling points (every 6 hours). The investigator will be pulling
blood film slides and plasma from the archive and quantify the parasitaemia and
HRP-2 concentrations respectively for any missing sampling point results. Data
collected will be analyzed using Parasite Clearance Estimator (PCE) beta 0.9. Expected Findings: We expect to see a significant difference in the parasite
clearance time within each drug and in between the two antimalarial drugs, quinine
and Artesunate. Results dissemination: Findings of this project are expected to be presented to COMREC, Malaria Study management team and to the general public through
different research dissemination conferences and in journal clubs.